90-minute sessions boost patient health and save physician's time

Updated 10:00 pm, Thursday, October 26, 2006

Dr. Dave Huntington reacts to a patient's joke Thursday during a "group visit" at Group Health's Northgate Medical Center.

Dr. Dave Huntington reacts to a patient's joke Thursday during a "group visit" at Group Health's Northgate Medical Center.

Photo: Meryl Schenker/Seattle Post-Intelligencer

The doctor is in -- for a nice, long 'group visit'

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Free 90-minute meetings with your primary care physician aren't a fantasy. Some Group Health members have been getting them since March 2005.

Thursday, 14 people who have participated in this pilot program since the beginning met at the Northgate Clinic to discuss memory -- how they're losing it, what they're doing to hang on to it and learning how to keep losses at bay.

These men and women have a lot in common. They are 65 or older and patients of Dr. Dave Huntington, a family practice physician with geriatric training. They've been gathering monthly for more than a year to learn from one another, get better acquainted with their doctor and learn about topics important to their health and well-being.

Huntington said the seminars give him an opportunity to interact with patients in a new ways. "They present themselves differently in a group than in the office. They play off each other," he said. It also allows him to give a message or advice once, instead of dozens of times.

"We have a lot of fun," said Margaret Thue, who has been with the group since it began. Getting better acquainted with her doctor and sharing information with a group are other benefits she mentioned.

Jack Richlen, a Group Health member since 1947, said the class gives him self-confidence, and he learns he's not the only one with issues. "It's important to be doing things, making new friends instead of sitting in front of the TV," he said.

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The sessions are voluntary and are meant to complement, rather than replace, one-on-one physician visits. They are for patients with common health interests, such as older people, people with diabetes or younger people seeking preventive care.

Dr. Martin Levine, a family physician at Group Health and geriatric specialist, is the mastermind behind the group visits. He was hired in 2001 and given an assignment: Find new ways to deliver care and take better care of patients. It had to be meaningful and make business sense, he said.

Levine did his homework, attended conferences, talked with people. He discovered group visits had existed sporadically throughout the country.

He received funding in the fall of 2004 to start the groups. His goal was to get 15 different doctors to do a group visit each month. Within nine months, they had 16 groups. Today, they're close to 30.

"They're tremendously popular. You get your doctor for 90 minutes. People learn from each other, learn they're not alone and they have fun," Levine said.

"Our dream is that one day we could promise all members they could have a group visit if they wanted. People who go to group visits get better care."

Thursday's group was ready and waiting at 10 a.m. when Huntington arrived to start their monthly session. He opened with comments about memory, noting that memory problems are universal. "We're going to concentrate on age-related memory and what we can do about it," he said.

He started around the table, asking each patient to describe a memory problem. One man said he kept forgetting to take his dinnertime pills, so he started hanging them right beside the front door so he couldn't leave for dinner without them.

Another said he recently ran into two people he didn't recognize and had to ask their names. One was a former student, another a former colleague. "It was truly embarrassing," he said.

Huntington smoothly and soothingly explained that "facing memory loss is one of the scariest things we do, but forgetting names doesn't mean it's the onset of Alzheimer's."

Another participant said she had become lost on her way to the clinic that morning, a first-time experience that had left her agitated and upset. Huntington explained it was important to have a strategy for finding your way when confused, or locating your car in a parking lot.

It could mean mapping out your route and keeping it next to you on the front seat, or noting landmarks, row numbers and other data when parking.

When one man was asked if he had memory problems, he said, "I don't remember anything except for what happened 50 years ago." That brought laughs and nods of understanding all around the room.

Huntington said communicating and keeping things simple can help deal with memory problems. Can't remember names? Picture the name written on the person's forehead when introduced. Repeat a person's name right after you meet -- for example, "Nice to meet you, John Jones" -- and then use the name again as soon as possible.

Huntington hit a nerve when he asked if any of his patients had hidden something they couldn't find later. Hands shot up all over the room, and everyone laughed. He recommended keeping all important things in one place, even if it is the back of the linen closet. Then write down where they are.

"Do not use Post-it notes," a woman advised the group. She said she'd recently had a cognitive assessment and learned some new tricks to keep track of her life. She learned Post-its get lost or stuck in unseen places. She was advised to use a colored tablet. She chose one in hot pink. She writes important things down and dates them. All the info she needs is on the tablet.

Huntington tactfully shifted topics, noting that "sharing" ran longer than usual this morning. He wanted to make a couple of points on decline versus disease.

He said it was important for doctors to separate the two. Decline could be something as simple as loss of speed when mall-walking, a natural decline. Disease is something that can be treated.

He helped the class put together a list of diseases that could affect memory loss. They came up with dementia, strokes, brain trauma, B-12 deficiency, low thyroid, medications, alcoholism, syphilis, recreational drugs. Even heart-lung bypass machines used in heart surgery can create a condition doctors call "pump head" (memory loss related to time on the pump).

While this discussion was going on, a nurse arrived and began giving flu shots to those who wanted them. Someone quipped the shots were a special "take-away" from the session, a freebie.

Getting the group back on the memory track, Huntington noted there's a lot of hype about software that promises to stimulate the brain and crossword puzzles that keep the brain active. "They can't hurt," he said.

Be active. Active people have better memories. Stay socially connected and involved in cognitive activities, Huntington said. Then he told them about a recent study that determined people who ate their vegetables had as much as 40 percent less memory loss.